Yes! You can use AI to fill out Fidelity Advisor IRA Distribution Request for Automatic Rollover Accounts
The Fidelity Advisor IRA Distribution Request for Automatic Rollover Accounts is an official Fidelity Investments form that allows account holders to request a full distribution from a Rollover IRA or Roth IRA that was automatically established on their behalf through an employer-sponsored retirement plan rollover. The form covers key details including account owner information, reason for distribution, distribution delivery instructions, and federal and state income tax withholding elections. Completing this form accurately is essential to ensure proper tax reporting and avoid potential penalties related to early withdrawals or missed minimum required distributions. Today, this form can be filled out quickly and accurately using AI-powered services like Instafill.ai, which can also convert non-fillable PDF versions into interactive fillable forms.
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Form specifications
| Form name: | Fidelity Advisor IRA Distribution Request for Automatic Rollover Accounts |
| Number of pages: | 1 |
| Filled form examples: | Form Fidelity Advisor IRA Distribution Request Examples |
| Language: | English |
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How to Fill Out Fidelity Advisor IRA Distribution Request Online for Free in 2026
Are you looking to fill out a FIDELITY ADVISOR IRA DISTRIBUTION REQUEST form online quickly and accurately? Instafill.ai offers the #1 AI-powered PDF filling software of 2026, allowing you to complete your FIDELITY ADVISOR IRA DISTRIBUTION REQUEST form in just 37 seconds or less.
Follow these steps to fill out your FIDELITY ADVISOR IRA DISTRIBUTION REQUEST form online using Instafill.ai:
- 1 Navigate to Instafill.ai and upload the Fidelity Advisor IRA Distribution Request form or select it from the available form library.
- 2 Enter your account owner information in Section 1, including your first name, last name, Social Security Number, existing Rollover IRA account number, date of birth, mobile phone number, email address, and current mailing address.
- 3 Review and acknowledge the Electronic Delivery consent in Section 2, confirming your email address for receiving account-related communications electronically.
- 4 Select the appropriate reason for distribution in Section 3, such as Normal Distribution, Early Distribution, Disability, or Direct Rollover to an eligible retirement plan, and provide trustee information if applicable.
- 5 Choose your preferred distribution method in Section 4, indicating whether the check should be sent to your address of record, via overnight delivery, or to an alternate address.
- 6 Complete the federal and state income tax withholding elections in Section 5, specifying whether you want taxes withheld and at what percentage or dollar amount.
- 7 Review all entered information for accuracy, print your name, sign and date the form in Section 6, and submit the completed form to Fidelity via upload through Accounts.Fidelity.com, fax, or mail as instructed.
Our AI-powered system ensures each field is filled out correctly, reducing errors and saving you time.
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Frequently Asked Questions About Form Fidelity Advisor IRA Distribution Request
This form is used to authorize a full distribution of your Fidelity Advisor Rollover IRA or Roth IRA that was automatically established by your former employer on your behalf through the rollover of assets from your former employer's retirement savings plan. It allows you to request a complete liquidation of that account.
This form is for individuals who have a Fidelity Advisor Rollover IRA or Roth IRA that was automatically set up by a former employer when they left that job. If you want to take a full distribution from that automatically established account, you must complete this form.
You will need to provide your full name, Social Security Number (SSN), existing Rollover IRA account number, date of birth, mobile phone number, email address, and current street address. All fields in this section are required. Your account number can be found on the confirmation statement from your automatic rollover, or you can call Fidelity at 800-248-4253 if you cannot locate it.
If you are under 59½, your withdrawal is generally subject to a 10% early withdrawal penalty in addition to ordinary income taxes. You may also be required to file IRS Form 5329. If you plan to roll over the distribution within 60 days, Fidelity is still required to report the withdrawal to the IRS on Form 1099-R as an Early Distribution (Code 1 or J).
For a Rollover IRA, you can choose: Code 7 (Normal Distribution, age 59½ or older), Code 1 (Early Distribution, under 59½, no known exception), Code 3 (Disability, under 59½), or Code G (Direct rollover to an eligible employer retirement plan). For a Roth IRA, choose Code T (age 59½ or older or disabled) or Code J (Early Distribution, under 59½). Select the code that matches your current situation.
No, this form should not be used for transfers to another institution. If you want to transfer assets from your Fidelity Advisor Rollover IRA or Roth IRA to an IRA at another institution, you should contact that institution directly for their requirements. Fidelity (FIIOC) will need to receive a letter of acceptance from the receiving institution to complete the transfer.
The default federal withholding rate is 10% of the gross distribution (excluding Roth IRAs). You can elect NOT to have federal taxes withheld, or you can choose a different rate between 1% and 100%. If you make no election, Fidelity will automatically withhold 10%. Note that for payments delivered outside the United States, you generally cannot choose less than 10%.
State tax withholding rules vary significantly by state. Some states (like AK, FL, TX, and others) do not allow state tax withholding at all. Some states have voluntary withholding, while others (like CA, MA, MN, and others) have mandatory minimum withholding rates. Refer to the Notice of Withholding included with the form or consult your tax advisor for your specific state's requirements.
A Roth IRA distribution is considered qualified if the 5-year aging period requirement is satisfied AND you are age 59½ or older, or disabled as defined by the IRS. The 5-year period begins on January 1 of the first year you made a contribution to any Roth IRA. If you do not meet these requirements, your distribution may be subject to income tax and a 10% early withdrawal penalty.
You can submit the form in three ways: upload it online by logging into Accounts.Fidelity.com and using the 'Upload Documents' link under 'Manage Accounts'; send it by fax to 888-321-7349; or mail it to Fidelity Investments Institutional Operations Company LLC, P.O. Box 770002, Cincinnati, OH 45277-0082 (or use the overnight address: 100 Crosby Parkway, KC1G, Covington, KY 41015). Note that if an original signature guarantee or notary is required, the form must be mailed.
Yes, Section 4 allows you to choose to have the check sent to an alternate address. You can also request overnight delivery of your check for a $20 fee, but overnight delivery is only available if you are not updating your address in Section 1. If you are sending the check to a new address, it will be sent via regular mail.
Under IRS rules, you must begin receiving minimum required distributions from your Rollover IRA by April 1 following the calendar year in which you turn 73. Failure to take the required distribution could result in substantial penalties. Contact your tax advisor or local IRS office for details on calculating your MRD.
Yes, AI-powered services like Instafill.ai can help you accurately auto-fill the form fields, saving you time and reducing errors. If you have a flat, non-fillable PDF version of this form, Instafill.ai can also convert it into an interactive fillable form so you can complete it digitally.
To fill out this form online, visit Instafill.ai and upload the Fidelity Advisor IRA Distribution Request PDF. The AI will guide you through each field—such as your account information, distribution reason, and tax withholding elections—auto-filling where possible. Once complete, you can download the filled form and submit it to Fidelity via upload, fax, or mail.
For assistance, you can contact your Financial Representative or call Fidelity's Retirement Specialists at 800-522-7297, available any day the New York Stock Exchange is open. If you cannot locate your account number, call 800-248-4253. You may also consult a tax advisor for questions about withholding, penalties, or Roth IRA qualification rules.
Compliance Fidelity Advisor IRA Distribution Request
Validation Checks by Instafill.ai
1
Social Security Number (SSN) Format and Completeness Validation
Validates that the SSN field (AC_SSN) contains exactly 9 numeric digits in the standard format (XXX-XX-XXXX or 9 consecutive digits). The SSN is required for IRS tax reporting purposes, as Fidelity must issue a Form 1099-R for the distribution. If the SSN is missing, incorrectly formatted, or does not match IRS records, federal income tax will be automatically withheld at the default 10% rate and the form cannot be processed.
2
Date of Birth Format and Age-Based Distribution Code Consistency
Validates that the Date of Birth (AC_DOB) is in MM/DD/YYYY format, represents a valid calendar date, and is logically consistent with the distribution reason code selected in Section 3 (RD_Distribution). For example, if the account owner's calculated age is 59½ or older, an Early Distribution code (Code 1 or J) should not be selected, and conversely, if the owner is under 59½, a Normal Distribution code (Code 7 or T) should not be selected. Mismatches between age and distribution code could result in incorrect IRS tax reporting and potential penalties for the account holder.
3
Required Account Information Fields Completeness Check
Validates that all fields marked as required in Section 1 are populated, including Account Owner First Name (AC_FirstName), Last Name (AC_LastName), SSN (AC_SSN), Existing Rollover IRA Account Number (AC_Account), Date of Birth (AC_DOB), Mobile Phone Number (AI_MobileNumber), and Email Address (AI_Email). The form explicitly states 'All fields are required' in Section 1, and missing any of these fields will prevent the form from being processed. Incomplete submissions will be returned to the account owner, delaying the distribution.
4
Email Address Format Validation
Validates that the Email Address field (AI_Email) contains a properly formatted email address following the standard pattern (e.g., [email protected]), is not left blank, and does not belong to an authorized agent or representative as explicitly prohibited by the form's instructions. The email address is required for electronic delivery consent verification, and Fidelity will send a confirmation message to this address to complete the consent process. An invalid or agent-owned email address will prevent the electronic delivery consent from being confirmed and may delay processing.
5
Mobile Phone Number Format Validation
Validates that the Mobile Phone Number (AI_MobileNumber) is entered in a valid U.S. phone number format containing exactly 10 digits (e.g., XXX-XXX-XXXX or (XXX) XXX-XXXX), with no letters or special characters other than standard formatting. The mobile number is designated as the primary contact and is used by Fidelity to verify and authorize transactions via call or text message. An incorrectly formatted or missing phone number will prevent transaction verification and block form processing.
6
Exactly One Distribution Reason Code Selected
Validates that one and only one distribution reason code is selected in Section 3 (RD_Distribution), and that the selection is appropriate for the account type (Rollover IRA vs. Roth IRA). The form provides separate sets of codes for Rollover IRA accounts (Codes 7, 1, 3, G) and Roth IRA accounts (Codes T, J), and selecting a code from the wrong account type or selecting multiple codes would result in incorrect IRS Form 1099-R reporting. Failure to select exactly one valid code will cause the form to be rejected or result in an incorrect tax filing.
7
Trustee Employer Plan Name Required When Code G Is Selected
Validates that the Trustee of the Employer Plan field (RD_TrusteeEmployerPlan) is populated when distribution reason Code G (Distribution from an IRA to an eligible Retirement Plan) is selected in Section 3. Code G requires the distribution check to be made payable to the trustee of an employer's plan, and without the trustee name, the check cannot be properly issued. If this field is left blank while Code G is selected, the form cannot be processed and the direct rollover cannot be completed.
8
Exactly One Distribution Method Selected in Section 4
Validates that one and only one distribution method is selected in Section 4 (DI_Check), choosing between distributing by check to the address of record (Option A) or distributing by check to an alternate address (Option B). Selecting both options or neither option creates an ambiguous instruction that Fidelity cannot act upon. If no selection is made or multiple selections are made, the form will be considered incomplete and returned for correction, delaying the distribution.
9
Alternate Address Fields Completeness When Option B Is Selected
Validates that when the alternate address distribution option (Option B) is selected in Section 4, all required alternate address fields are populated, including DI_Address (street address), DI_City, DI_State, and DI_Zip. A complete mailing address is necessary to ensure the distribution check is delivered to the correct location. Missing address components will result in an undeliverable check or the check being sent to the address of record instead, which may not be the account owner's intent.
10
Overnight Delivery Eligibility Consistency Check
Validates that the overnight check delivery option (DI_Overnight) is only selected when the distribution method is Option A (check to address of record) and the checkbox to update the address in Section 1 is not checked. The form explicitly states that overnight delivery is only available if the new address box in Section 1 is unchecked, and if a new address is provided, the check will be sent via regular mail regardless. Selecting overnight delivery with a new address update would create a conflict that must be flagged to set proper expectations with the account owner.
11
Federal Tax Withholding Election Completeness and Percentage Range Validation
Validates that exactly one federal tax withholding election is made in Section 5 (FS_Tax), and if a specific percentage is elected, the value entered in FS_Percentage is a whole number between 1 and 100. If no election is made, the default 10% withholding rate applies per IRS regulations, but the form should flag this to ensure the account owner is aware. Additionally, for distributions to be delivered outside the United States, the system must verify that the withholding rate is not less than 10%, as IRS rules prohibit lower rates for international deliveries.
12
State Tax Withholding Eligibility Based on State of Residence
Validates that the state tax withholding election (FS_TaxState) is consistent with the rules applicable to the account owner's state of residence as indicated in AC_State. For residents of states where withholding is not allowed (AK, FL, HI, NH, NV, SD, TN, TX, WA, WY), any state withholding election must be rejected. For mandatory withholding states (AR, CA, DE, IA, KS, MA, ME, MI, MN, NC, OK, OR, VT), the system must ensure the minimum required withholding rate is applied. Incorrect state withholding elections can result in under-withholding penalties or non-compliance with state tax laws.
13
Dollar Amount Provided for States Without Minimum Withholding Requirement
Validates that when a state income tax withholding election is made for states that have no minimum withholding requirement (IL, IN, KY, MD, NJ, NY, OH, PA, RI), a specific dollar amount is entered in the FS_Amount field. These states require a dollar amount to be specified because there is no default minimum rate to apply, and without a dollar amount, the withholding election cannot be executed. If the dollar amount is missing for these states, the state withholding election will be treated as invalid and no state tax will be withheld.
14
Signature and Date Presence and Format Validation
Validates that the Signature field (SD_Shareholder) is not blank and that the Date field (SD_Date) is populated in MM-DD-YYYY format with a valid calendar date that is not in the future. The form explicitly states it 'cannot be processed without signature and date,' making these fields absolutely mandatory for authorization. A missing signature or date, or a date that is in the future or predates the account establishment, will result in the form being rejected and returned to the account owner.
15
Printed Name Matches Account Owner Name in Section 1
Validates that the printed name in the Print field on the signature page is consistent with the Account Owner First Name (AC_FirstName), Middle Initial (AC_Middle), and Last Name (AC_LastName) provided in Section 1. This cross-field consistency check ensures that the person signing the form is the account owner or an authorized signer, and that there is no discrepancy that could indicate an unauthorized distribution request. A mismatch between the printed name and the account information may require additional verification or a signature guarantee before the form can be processed.
16
IRA Account Number Format and Presence Validation
Validates that the Existing Rollover IRA Account Number (AC_Account) is populated and conforms to Fidelity's expected account number format (typically a numeric string of a defined length). This account number identifies the specific Rollover IRA or Roth IRA to be fully liquidated, and an incorrect or missing account number would result in the distribution being applied to the wrong account or the form being rejected. If the account number cannot be located, the form instructs the owner to call Fidelity at 800-248-4253, and the system should flag missing or improperly formatted account numbers for follow-up.
Common Mistakes in Completing Fidelity Advisor IRA Distribution Request
Many people cannot locate their Rollover IRA account number because it was automatically established by their former employer, and they may never have actively set it up themselves. Without the correct account number, Fidelity cannot process the distribution request. The account number can be found on the confirmation statement sent when the automatic rollover was established; if unavailable, account holders should call Fidelity at 800-248-4253 before submitting the form. Tools like Instafill.ai can help flag this field as incomplete before submission.
People frequently check the wrong distribution reason in Section 3, such as selecting 'Normal Distribution (Code 7)' when they are actually under 59½, or failing to select the 'Disability' option when applicable. Choosing the wrong code can result in incorrect IRS reporting, unexpected tax penalties, or the need to file additional forms like IRS Form 5329. Filers should carefully verify their age and circumstances against each option before checking a box, and consult a tax advisor if unsure which code applies to their situation.
Many account holders under age 59½ are unaware that their distribution will be subject to a 10% early withdrawal penalty in addition to ordinary income tax, and they fail to account for this when planning their finances. This misunderstanding can lead to unexpected tax bills and underpayment penalties. The form clearly notes in Section A (Note 2) that IRS Form 5329 may need to be filed, but filers often overlook this requirement. Always consult a tax advisor before requesting a distribution if you are under 59½.
Section 1 explicitly states that both a mobile phone number and email address are required to verify and/or authorize transactions, yet many filers leave one or both fields blank. Without this information, Fidelity cannot send the electronic consent confirmation required in Section 2, which can delay or prevent processing of the distribution. Filers should ensure both fields are filled with current, accurate contact information they actively monitor. AI-powered form tools like Instafill.ai can flag these required fields as empty before the form is submitted.
The IRS requires a U.S. residential address for tax withholding purposes, and the Notice of Withholding explicitly states that a post office box does not qualify as a U.S. residential address. Submitting a P.O. Box may result in mandatory federal income tax withholding being applied regardless of the filer's election. Filers must provide a valid physical street address in Section 1 to ensure their withholding elections are honored. If the address on file needs to be updated, the checkbox in Section 1 must also be selected.
Many filers either leave the federal tax withholding section blank or select a withholding rate without considering their total income and tax bracket, resulting in under- or over-withholding. If no box is checked, Fidelity defaults to withholding 10%, which may not be appropriate for the filer's tax situation. The form includes a W-4R Marginal Rate Table to help filers calculate the correct withholding rate based on their filing status and total income. Filers should review the 2025 Marginal Rate Tables provided with the form and consult a tax advisor to select the most appropriate rate.
State tax withholding requirements vary significantly — some states mandate withholding, some allow voluntary withholding, and others do not permit it at all. Filers often apply a one-size-fits-all approach, either electing state withholding when their state doesn't allow it or failing to elect it when it is mandatory (e.g., residents of CT, MI, MN, or OK). Failing to comply with state-specific rules can result in underpayment penalties at the state level. Filers should carefully review the State Tax Withholding matrix in the Notice of Withholding to determine the rules for their specific state of residence.
Some account holders mistakenly use this Distribution Request form when they actually want to transfer their IRA assets to another institution, which is a fundamentally different transaction. Note 4 in Section A explicitly states that this form should NOT be used for transfers, and that the receiving institution must provide a letter of acceptance to FIIOC. Using the wrong form for a transfer can cause delays, unintended tax consequences, or the distribution being processed as a taxable withdrawal. Filers who want to transfer assets should contact the receiving institution directly for their specific transfer requirements.
Roth IRA account holders frequently request distributions without verifying whether they meet the 5-year aging period requirement and the age/disability criteria needed for a qualified, tax-free distribution. If these requirements are not met, the distribution may be subject to income tax and a 10% early withdrawal penalty, which can be a costly surprise. Note 5 in Section A provides detailed guidance on the 5-year rule, including how rollover contributions are treated. Filers should consult a tax advisor to confirm whether their Roth IRA distribution qualifies before submitting this form.
Some filers check the overnight delivery option in Section 4 without realizing it is only available when the address in Section 1 is the existing address of record (i.e., the 'Update address' checkbox must be unchecked). If a new address is being provided, the check will automatically be sent via regular mail regardless of the overnight selection, and the $20 fee may still apply. Filers who need expedited delivery should ensure they are not simultaneously updating their address on the form. Reading the asterisked note next to the overnight option carefully can prevent this confusion.
The form requires the date of birth in MM DD YYYY format, but filers commonly enter it in other formats such as MM/DD/YY, YYYY-MM-DD, or with slashes and dashes in the wrong places. An incorrectly formatted date of birth can cause processing errors or delays, and may affect the determination of which distribution code applies (e.g., whether the filer is over or under 59½). Filers should double-check that they are using the exact MM DD YYYY format as specified. AI-powered tools like Instafill.ai can automatically format date fields correctly to prevent this type of error.
Section 6 explicitly states the form cannot be processed without a signature and date, yet many filers submit the form without completing this section, causing significant processing delays. Additionally, the form requires the account owner's name to be printed in First, M.I., Last order in a separate field above the signature line, which is often skipped. The date must also be entered in MM-DD-YYYY format. Filers should review the entire form before submission to ensure Section 6 is fully completed, and use Instafill.ai to catch missing required fields like signatures and dates before finalizing.
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